COVID-19 is a virus that can affect all systems, and while most think first of it threatening our breathing, it can put a considerable burden on our skin too. As doctors, we’ve certainly seen increased numbers of skin rashes and associated skin problems, and there’s anecdotal evidence that it can impair wound healing. For 1 in 5 people with COVID-19, a skin sign may be the only symptom they get. COVID-19 skin signs fall into two categories – common conditions that have increased in number (such as urticarial), and rare conditions that have also increased, such as those affecting the toes or mouth. The COVID ZOE symptom app has looked at data from millions of people with COVID-19 symptoms. The doctors behind it, from Kings College London, have argued that skin signs are now so common with COVID-19 that it should be listed as a key sign of COVID-19 infection, alongside fever, cough and loss of sense of smell. It isn’t clear if the virus causes these changes directly or via the immune response it provokes, but nearly half appear at the time of infection, with about a third appearing following infection. It’s also worth noting that it’s common to get a rash after any mild viral illness, such as a cold.

Blood in the sputum is also known as haemoptysis. Sputum is usually the mucus substance you cough up from the airways and lungs. Phlegm is the specific term for the mixture of saliva and mucus from your nose, mouth and throat. There can be different causes for haemoptysis, some are serious, some are less so, but you should see your doctor in most circumstances, so they can work out the underlying cause. You may notice a few streaks in the sputum, which commonly come with a chest infection, or clots, or even a pink watery appearance, but these indicate an area of tissue damage, and warrant a discussion with your doctor.

A blocked nose is the feeling that the nasal passages are congested or stuffy. Depending on the individual, a blocked nose can affect each person quite differently. A blocked nose can occur over a short period (acute) or a long period (chronic) of time, which is usually regarded as more than three months. A blocked nose can occur with other symptoms which may give an indication of the cause. For example nasal discharge (rhinorrhoea), loss of sense of smell or taste (anosmia), sneezing and irritation, pain in the face or nasal bleeding. 

Anosmia is a condition that describes failure of our sense of smell. Although there are many other conditions that can cause anosmia, it has become well-known since the pandemic started, as it was classified as one of three typical symptoms of COVID-19 before people were vaccinated. Loss of sense of smell occurs during the acute COVID illness but can last long after you have since recovered. Your ability to smell is closely linked to your taste buds so it can make your food taste bland or alter your smell so that things either don’t smell of anything or smell very different. You may detect a charred or burning smell, and can have a knock-on effect on your appetite. You may only be able to smell or taste a little – partial anosmia – or you may find certain smells or tastes unpleasant. You may experience a bad smell all the time, like smelling smoke or petrol, even if it’s not present.

High temperature, fever, chills, or any other name you give it, is a sure sign that your body's immune system is at work trying to fight something off. The common causes of a high temperature are viruses or bacteria causing infection, but there are many other causes. You will normally feel unwell with a fever, and may be swinging from feeling cold and shivery and getting under the duvet to burning up and feeling hot and sweaty. You may have a hot head, chest or back when you put a hand to it.

Maskne is a new phenomenon coined in the COVID-19 pandemic to describe the acne experienced around the nose, upper lip and chin area in a response to regularly wearing a mask. Mask-provoked acne is new to the general public, anyway, but has long been experienced by medical and construction workers. The causes of these pimples, or whiteheads, are two-fold: the first is the physical barrier they provide, which causes pores to become blocked with the dead skin cells we shed all the time, so-called acne mechanica. A bacteria associated with acne, called P. Acnes, causes inflammation in blocked pores and sebaceous (oil-forming) glands, and in addition to the physical friction, masks also provide a warm, moist environment for P. Acnes to grow and multiply, thus further inflaming the spots, and even causing deep spots, called cysts.

Phlegm is also known as mucus and it is produced by your lungs to line the airways and protect them from foreign substances. It also provides moisture which helps to trap irritants and remove them from the body. In certain situations, your body might increase the production of mucus, for example, when you have an allergy or an infection, and that might cause you unpleasant symptoms. When you cough up phlegm from the lungs or back of the throat, it's often referred to as sputum. Looking at your phlegm or sputum can give you a lot of information about what could be causing your symptoms.

Coughs can prove to be quite bothersome. Typically stemming from viral or bacterial infections, new coughs can often be effectively managed at home without needing a doctor's visit. Where to start? Starting small by taking it easy, getting good amounts of sleep, and ensuring that you are eating and hydrated well will help. You can also try some simple over-the-counter treatments to help with your symptoms. Healthwords pharmacists have put together some of our favourite medications that can be purchased over the counter to help with a productive cough.

A cough is the body’s natural way of responding to irritation in your respiratory tract, causing muscles in the airways to contract and push out any irritant or infection in a burst of air. Your airways are covered in cells that produce mucus which aids in the removal of dust, bacteria, viruses and other debris. When you get a chest infection, your body produces more mucus than normal as it tries to remove the virus or bacteria. The excess mucus, known as phlegm or sputum, causes you to cough more frequently and forcefully – phlegm is then brought up and spat out or swallowed, destroying the pathogen and helping you recover. We call this a productive cough. Most chest infections and productive coughs are caused by viruses rather than bacteria. As antibiotics only work on bacterial infections, this means that they won’t have any effect on most chest infections.

This is characteristic of a fungal nail infection. Yellowing and thickening usually start at the tip, becoming soft and crumbly and harder to cut. Over weeks it can spread to the rest of the nail, replacing the healthy pink parts and causing it to lift off. Eventually, over the course of a few months, the whole infected nail may come off. People are usually bothered by the appearance, and only notice when summer announces itself and the flip flops come out, after a winter of feet in warm sweaty socks and shoes. It can occasionally cause swelling and pain. Tinea unguium, the medical term for fungal nail infection, is more common in the toenails than fingernails. It can affect one nail or several, usually on the same hand or foot, and can eventually spread to the other foot.

A sore throat is a pain, scratchiness or irritation of the throat that often worsens when your child swallows. It may come out of the blue if they’re fighting a viral or bacterial infection, and they may also experience cold symptoms like a runny or blocked nose, sneezing, a fever, coughing, headache, and they may complain of pain on swallowing. You might be able to feel the glands in their neck are enlarged and these can feel quite tender to touch. If you look in the back of their throat, you might see one or both tonsils are large and red, causing the gap between them to reduce, and you may notice some white spots on the tonsils.

Sweating normally occurs at night when the room, environment or bedding may be making you hot. Night sweats occur when you sweat excessively at night despite the surrounding environment being cool. In this case, it's likely that you will need to change nightwear and sheets, as they are soaked through. Persistent night sweats can be a sign of serious health conditions and should be checked with your doctor if they occur.